Organization Active NPI

Peter G. Stimpson MD Faafp PC

  • Family Medicine Physician
  • Loudon, TN
National Provider Identifier
1700059516
Registry record updated Apr 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
8483 Issued in TN
Legal business name
PETER G. STIMPSON MD FAAFP PC
Practice address
901 Grove St
Loudon, TN 37774-1601
Phone
(865) 458-4647
Fax
(865) 458-9412
NPI assigned
Apr 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Peter G Stimpson, MD
Title
Practice Owner
Phone
(865) 458-4647

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207K00000X 4971 TN
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 8483 TN Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 27033 TN
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 4971 TN

Addresses

Primary practice location

901 Grove St
Loudon, TN 37774-1601

Mailing address

901 Grove St
Loudon, TN 37774-1601
Phone (865) 458-4647

Other identifiers 3

IdentifierTypeStateIssuer
3094813MedicaidTN
3101689MedicaidTN
3157385MedicaidTN

National Provider Directory

National Provider Directory

Locations

901 Grove St
Loudon, TN 37774
Phone (865) 458-4647

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207958400000",
    "number": "1700059516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 GROVE ST",
            "city": "LOUDON",
            "state": "TN",
            "postal_code": "377741601",
            "telephone_number": "865-458-4647",
            "fax_number": "865-458-9412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 GROVE ST",
            "city": "LOUDON",
            "state": "TN",
            "postal_code": "377741601",
            "telephone_number": "865-458-4647",
            "fax_number": "865-458-9412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER G. STIMPSON MD FAAFP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-12",
        "last_updated": "2008-04-12",
        "status": "A",
        "authorized_official_last_name": "STIMPSON",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "865-458-4647",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": "TN",
            "license": "4971",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "8483",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "27033",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "4971",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3094813",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3101689",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3157385",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loudon, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.